ADVANCED IMPLANT AND ORAL SURGERY — NPI 1942703657 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery in YUMA, AZ)

CMS-1500 Box 24J / 33a • NPI

1942703657

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

204E00000X (CMS 02)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery

Box 32 Service Location & ZIP+4

1325 W 16TH ST STE 3, YUMA, AZ, 85364-4496

✓ 9-Digit EDI 837 ZIP+4 (85364-4496)

Practice Phone & Referral Fax

(928) 329-6447

Fax: (928) 782-8036

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1942703657 (ADVANCED IMPLANT AND ORAL SURGERY) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1942703657` (NPI-2 Organization / Facility)
Provider / Legal Name	ADVANCED IMPLANT AND ORAL SURGERY
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery NUCC Code: `204E00000X` (Oral & Maxillofacial Surgery)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1325 W 16TH ST STE 3, YUMA, AZ, 85364-4496
Practice Telephone / Fax	Tel: (928) 329-6447 \| Fax: (928) 782-8036
Administrative Mailing Address	1325 W 16TH ST STE 3, YUMA, AZ, 85364-4496
Enumeration & Last Sync	Enumerated: 2018-03-09 \| CMS Record Updated: 2018-04-17
Authorized Official	PETER SPANGANBERG (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1325 W 16TH ST STE 3, YUMA, AZ, 85364-4496

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Plain-English Taxonomy & CMS Crosswalk (204E00000X)

What Does Taxonomy Code 204E00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 204E00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery) • CMS Code 85 (Physician/Maxillofacial Surgery)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Oral & Maxillofacial Surgery for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ADVANCED IMPLANT AND ORAL SURGERY)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QS0112X` — Clinic/Center, Oral and Maxillofacial Surgery Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Secondary
`204E00000X` — Oral & Maxillofacial Surgery Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ADVANCED IMPLANT AND ORAL SURGERY (NPI #1942703657)